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Three-Dimensional Assessment of Maxillary Stability Using Customized Plates in Orthognathic Surgery: A Retrospective
Leonardo Aguilar1,2, Juan Pablo Vargas Buratovic3, Valentina Matamala Ibaceta4
1Department of Oral and Maxillofacial Surgery, RedSalud Providencia Clinic, Santiago 7500995, Chile.
Craniomaxillofacial Trauma & Reconstruction
|June 25, 2026
Summary
Patient-specific implants (PSIs) in orthognathic surgery provide stable results. Minimally invasive plates match conventional designs, but multisegmental osteotomies require careful management to prevent localized instability.
Area of Science:
- Orthognathic Surgery
- Biomedical Engineering
- Skeletal Reconstruction
Background:
- Patient-specific implants (PSIs) enhance intraoperative accuracy in orthognathic surgery.
- Limited evidence exists on the postoperative skeletal stability of PSIs, particularly concerning fixation designs and segmentation patterns.
Purpose of the Study:
- To compare the 3D skeletal stability of different fixation designs and maxillary segmentation patterns in patient-specific implants used for orthognathic surgery.
Main Methods:
- Retrospective cohort study of 64 adult patients undergoing customized maxillary orthognathic surgery.
- Compared conventional vs. minimally invasive plates and monoblock vs. multisegmental maxillary segmentation.
- Assessed 3D skeletal stability via linear displacement between preoperative and 6-month postoperative imaging.
Main Results:
- Median displacement ranged from 0.7 to 4.28 mm; 28.1% of patients showed displacement ≥ 2.0 mm, mainly in molar/canine regions.
- No significant difference in instability rates between single-segment and multisegmental osteotomies (p=0.28).
- Multisegmental cases had higher displacement at the left canine (p=0.027); plate design showed no association with instability (p=0.88).
Conclusions:
- Customized maxillary PSIs offer reliable postoperative stability with median displacements generally within acceptable limits.
- Minimally invasive PSI designs provide stability comparable to conventional designs.
- Multisegmental osteotomies may require specific biomechanical management to address localized instability.
